| Chronic Obstructive Pulmonary Disease: Quantification of Bronchodilator Effects by Using Hyperpolarized He MR Imaging. | |
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MedLine Citation:
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PMID: 21813741 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Purpose: To evaluate short-acting bronchodilator effects in chronic obstructive pulmonary disease (COPD) by using hyperpolarized helium 3 ((3)He) magnetic resonance (MR) imaging, spirometry, and plethysmography. Materials and Methods: Fourteen ex-smokers with COPD provided written informed consent to a local ethics board-approved and Health Insurance and Portability Accountability Act-compliant protocol and underwent hyperpolarized (3)He and hydrogen 1 MR imaging, spirometry, and plethysmography before and a mean of 25 minutes ± 2 (standard deviation) after administration of 400 μg salbutamol. Distribution of (3)He gas was evaluated by using semiautomated segmentation of (3)He voxel intensities, where cluster 1 represented regions of signal void or ventilation defect volume (VDV), and clusters 2-5 (C2-C5) represented gradations of signal intensity from hypointensity (C2) to hyperintensity (C5). (3)He ventilation defect percentage (VDP) was calculated as VDV normalized to the thoracic cavity volume. Comparisons of pre- and post-salbutamol means were performed by using a two-way mixed-design repeated measures analysis of variance, and comparisons of the magnitude of the treatment effect between pulmonary function and (3)He MR imaging measurements were performed by using effect size (ES) calculations. The relationships between pulmonary function and (3)He MR imaging findings were determined by using Spearman correlation coefficients. Results: After salbutamol administration, there were significant changes in forced expiratory volume in 1 second (FEV(1)) (P = .001), total lung capacity (P = .04), and functional residual capacity (P = .03), as well as VDP (P < .0001) and (3)He gas distribution (C2, P = .01; C3, P = .03; C4, P < .0001; and C5, P = .02). Treatment ES was greater for (3)He VDP than for FEV(1) (0.50 vs 0.22). There was a significant correlation between baseline VDP and post-salbutamol FEV(1) change (r = -0.77, P = .001). Although five patients were classified as bronchodilator responders and nine patients were classified as bronchodilator nonresponders according to American Thoracic Society and European Respiratory Society criteria, there was no significant difference in the magnitude of the (3)He MR imaging changes after salbutamol administration between responder groups. Conclusion: (3)He MR imaging depicted significant improvements in the distribution of (3)He gas after bronchodilator therapy in ex-smokers with COPD with and those without clinically important changes in FEV(1). © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11110403/-/DC1. |
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Authors:
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Miranda Kirby; Lindsay Mathew; Mohammadreza Heydarian; Roya Etemad-Rezai; David G McCormack; Grace Parraga |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-3 |
Journal Detail:
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Title: Radiology Volume: - ISSN: 1527-1315 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Imaging Research Laboratories, Robarts Research Institute, 100 Perth Dr, London, ON, Canada N6A 5K8; Department of Medical Biophysics, Department of Medical Imaging, Division of Respirology, Department of Medicine, and Graduate Program in Biomedical Engineering, University of Western Ontario, London, Ont, Canada. |
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